Este estudo apresentou como meta contribuir para o ensino da disciplina de administração de enfermagem hospitalar, através de uma experiência de desenvolvimento profissional de professores-pesquisadores, em um processo crítico-reflexivo sobre a sua prática docente. A trajetória metodológica da pesquisa-ação, foi operacionalizada em duas etapas: na primeira, foram identificadas as situações dilemáticas acontecidas no estágio disciplinar, por intermédio da reflexão sobre a reflexão-na-ação feita por uma professora após a supervisão diária dos alunos; na segunda, foram efetuados os círculos de reflexão por todos os professores que ministraram a disciplina no período da coleta de dados, utilizando como ponto de partida as situações dilemáticas identificadas anteriormente. A análise temática dos dados coletados nos círculos de reflexão revelou que a reflexão realizada entre os pares possibilitou a objetivação dos saberes experienciais dos professores, assim como a construção de novos saberes pedagógicos. Os saberes docentes elaborados durante os círculos de reflexão foram utilizados para propor mudanças na referida disciplina. / This study aims to contribute to the teaching of the subject Hospital Management Nursing, through an experience of professional empowerment of teachers-researchers, using a critical-reflexive approach to their teaching practices. The study followed the action-research methods, in two stages: first, the “dilemma” situations teachers faced in the disciplinary training of students, were identified through the reflection about the “reflection-on-action” process, used by a teacher after daily supervision of students; second, all the teachers responsible for the classes during the data collection period, participated of “reflection circles”, using as starting point, the “dilemma” situations previously identified. Thematic content analysis of data obtained on these “reflection circles” revealed that reflection done among pairs turned objective the experiential knowledge of the teachers, and also made possible the construction of new pedagogic knowledge. This teaching knowledge was used to propose a change on the subject of Hospital Management Nursing for a graduation course.

O presente trabalho teve como tema de investigação a formação de professores à luz da História e Cultura Afro-brasileira e Africana. A questão aqui abordada diz respeito às contribuições teóricas e metodológicas dos conteúdos e atividades na formação de professores reflexivos, e na instrumentalização, capacitação e fundamentação destes, para realizarem a transposição didática dos conteúdos, com vistas ao tratamento pedagógico adequado das questões raciais dentro do espaço escolar. Para a realização desta pesquisa, foi analisada a iniciativa desenvolvida pelo curso Escola Plural: a diversidade está na sala de aula, ministrado pelo Ceafro Educação e Profissionalização para a Igualdade Racial e de Gênero junto à Secretaria Municipal de Educação de Salvador. Trata-se de uma pesquisa qualitativa em que estudos de caso com características da autobiografia educativa aliada à análise de fontes documentais estão sendo realizados com seis professoras da Rede Municipal, sendo três participantes da formação e três não-participantes. Tal configuração dos sujeitos deve-se ao fato de considerarmos que esta nos possibilitaria uma discussão e análise comparativa do possível real impacto da formação na prática dos docentes. Além desses participantes, trazemos também os relatos de formadores do Ceafro, que favoreceram a compreensão do processo formativo desde a sua concepção até a sua concretização. Privilegiamos na análise as contribuições de autores que se dedicaram ao estudo das questões raciais no Brasil - como Petronilha Beatriz Gonçalves e Silva, Kabengele Munanga, Eliane Cavalleiro, Nilma Lino Gomes, Carlos Hasenbalg, entre outros -, bem como aos que contribuíram para os estudos sobre a formação de professores e o entendimento do conceito de professor reflexivo - como Perrenoud, Carlos Libâneo, Zeichner, Donald Schön, Antônio Nóvoa e Contreras -, e por fim, aos que se dedicaram a elucidação do conceito de transposição didática, como Chevallard. A partir da análise dos dados, levando-se em conta as categorias de sujeitos implicados neste estudo, foi possível apontar alguns aspectos marcantes por eles apresentados, tais como: o reconhecimento da existência do racismo no Brasil e da escola enquanto espaço privilegiado de suas manifestações; a existência de lacunas na formação de professores, o que demanda uma formação mais consistente na temática; as dificuldades no trato das questões religiosas; a importância do trabalho com a identidade como fio condutor da formação; a pesquisa e a reflexão como estratégias; e os problemas da descontinuidade da formação no espaço escolar, entre outros. / The present work has as its main theme the training of teachers in the light of Afro-American and African history and culture. The question addressed here regards the theoretical and methodological contribution of contents and activities in the training of reflexive teachers, and in their equipping, qualification, and foundation to achieve a didactic transmission of contents, with a view to the adequate pedagogic treatment of racial issues in the schoolroom. For this research, the initiative developed by the Plural School course is analyzed: The diversity is in the classroom, administered by Ceafro Education and Professionalization for Racial and Gender Equality together with Salvadors Municipal Education Secretary. Its treated as a qualitative study, in which case studies with characteristics of the educative autobiography together with to documented sources are being done with six teachers of the Municipal Network, of whom three of them had participated in the course and the others did not. Such a choice of subjects was made so that we may consider that this allows us to engage in discussion/comparative analysis of the possible real impact of formation in the docents practice. As well as these participants, there are three accounts of Ceafro`s trainees that helped in the understanding of the training process from the conception to the initiation. We emphasize at the analysis the contributions of authors who dedicate themselves to the study of racial issues in Brazil such as Petronilha Beatriz Gonçalves e Silva, Kabengele Munanga, Eliane Cavalleiro, Nilma Lino Gomes, Carlos Hasenbalg, among others -, as well as those who contributed to the studies in teachers training and understanding of the concept of reflexive teacher such as Perrenoud, Carlos Libâneo, Zeichner, Donald Schön, Antônio Nóvoa e Contreras -, and finally, those who dedicated themselves to the elucidation of the concept of didactic transposition, such as Chevallard. From the analysis of data, and considering the three categories of subjects in this study, it was possible to point to some important aspects highlighted by them such as: the recognition of the existence of racism in Brazil and the school as a privileged space for its manifestation; existence of gaps in the training of teachers, that shows the importance of a consistent training on this theme; the difficulties in the treatment of religious questions; the importance of the work with the identity as conduit for trainng; research and reflection as strategies; and the problems of the discontinuation of teacher training in the school environment, among others.

Assim como o professor que ele pretende educar, o formador também traz consigo suas crenças, suas experiências pessoais e modelos que incorporou ao longo de sua própria formação e caminhada como profissional. Desse modo, o formador também é um sujeito que enfrenta dificuldades, que se submete a riscos, que se encontra dividido entre seus medos e seus desejos, submetido à sua inteligência e sua intuição e é vítima de seus contrastes. Por isso, focalizamos nossa atenção no formador, investigando suas ações e questionamentos no interior dos cursos de formação continuada, especialmente no que se refere ao enfrentamento de seus impasses. Privilegiando os aspectos da subjetividade dos formadores, tentaremos compreender em que medida essas ações e questionamentos, explícita e implicitamente, podem influenciar a prática dos formadores e gerar impacto sobre os professores em formação. No contexto das ações e questionamentos, exploramos os referenciais teóricos da reflexão-ação (D. Schön) e do professor reflexivo (K. Zeichner), cujas origens remontam ao pensamento reflexivo (J. Dewey). Uma vez que esses modelos teóricos, crescentemente valorizados no campo da formação continuada, não consideram que o plano inconsciente atua e intervém nos pensamentos e nas ações dos sujeitos, discutimos e ampliamos seus limites enquanto teoria e prática, à luz do referencial teórico da psicanálise. S. Freud, J. Lacan e demais autores que acreditam na possibilidade de articular psicanálise e educação, serviram como suporte para as nossas análises. Em particular, exploramos principalmente os conceitos de transferência, Outro, gozo e desejo, analisando as posições subjetivas dos sujeitos pesquisados em relação a esses elementos, enquanto exercem a função de ou assumem um lugar como formadores de professores. Neste trabalho, sustentamos a tese de que o questionamento das posições subjetivas dos sujeitos, por meio da prática de uma reflexão mais profunda e perturbadora, revele-se mais promissora para se alcançar mudanças satisfatórias na prática docente. Por fim, são sugeridas algumas pistas que podem auxiliar na construção de um novo formato para os cursos de formação. / Just like the teacher they intend to educate, a teacher educator also holds their beliefs, their personal experience and models, which they have acquired throughout their own education and professional development. Therefore, the educator is also someone who faces difficulties, who is subject to taking risks, who finds themselves at a crossroads, divided over their fears and wishes, victims of their contrasts, and submitted to their intelligence and intuition. For this reason, we have turned our attention to the educator, studying their actions and queries along continuing education courses, mainly concerning the way they deal with their dilemmas. Focusing on the educators subjective aspects, we are going to try to understand to what extent their actions and queries may, either explicitly or implicitly, influence the educators practice and impact on the teachers being prepared. As far as actions and queries are concerned, we have stuck to the theoretical references of the reflection-action (D. Schön) as well as to those of the reflexive professor (K. Zeichner), the origins of which are found in the reflexive thought (J. Dewey). Since these theoretical models, increasingly valued within the continuing education scope, do not take into consideration that the unconscious level works and interferes in peoples thoughts and actions, we have discussed and widened their limits regarding theory and practice according to psychoanalysis theoretical reference. S. Freud, J. Lacan and other authors who believe it is possible to articulate psychoanalysis and education provided the support for our analysis. We were mainly concerned with the concepts of transference, the Other, enjoyment and desire, analyzing the subjective attitude of the individuals studied in relation to these elements, as they play the role or take over the position of teacher educators. In this study, we support the idea that questioning educators subjective attitudes, through a deeper and disturbing reflection, may turn out to be more promising in the search for satisfactory changes in teaching practice. Finally, we provide some hints which may help pave the way for a new format for teacher education courses.

The purpose of this study is to examine the challenges and support for newly graduated social workers during their first two years of professional practice and how this relates to work introduction and professional organization. Previous research indicates that the transition from social work education to becoming a social worker within social services is challenging. Newly graduated social workers require careful introduction and support from experienced colleagues to feel confident in their role. Improved introduction and more tailored support can facilitate the transition to the work. This study focuses on the experiences of newly graduated social workers during the initial professional period. In this study, the theories of symbolic interactionism "I" and "Me", dynamic development process, and reflective practice are used to understand the interaction and socialization within the professional role as social worker. The method used in this study is a qualitative approach to understand the experiences of newly graduated social workers in their professional life. The results of this study indicate a significant change and an overwhelming sense of responsibility compared to the time spent in education. Furthermore, shortcomings in educational preparation for practical work, especially in authority exercises, are highlighted. Practical experience, including internships within social services, facilitates the transition and boosts the confidence of newly graduated social workers. Challenges identified in this study include high workload, uncertainty in client work, and managing prejudices and expectations from clients. The results also show that support from colleagues, supervisors, and training is crucial for professional development. Requests for longer, more structured introductions and reduced workload are emphasized to improve the transition to professional life and promote well-being.

INTRODUCTION : Les soins de première ligne au Québec vivent depuis quelques années une réorganisation importante. Les GMF, les cliniques réseaux, les CSSS, les réseaux locaux de service, ne sont que quelques exemples des nouveaux modes d’organisation qui voient le jour actuellement. La collaboration interprofessionnelle se trouve au cœur de ces changements. MÉTHODOLOGIE : Il s’agit d’une étude de cas unique, effectuée dans un GMF de deuxième vague. Les données ont été recueillies par des entrevues semi-dirigées auprès du médecin responsable du GMF, des médecins et des infirmières du GMF, et du cadre responsable des infirmières au CSSS. Les entrevues se sont déroulées jusqu’à saturation empirique. Des documents concernant les outils cliniques et les outils de communication ont aussi été consultés. RÉSULTATS : À travers un processus itératif touchant les éléments interactionnels et organisationnels, par l’évolution vers une culture différente, des ajustements mutuels ont pu être réalisés et les pratiques cliniques se sont réellement modifiées au sein du GMF étudié. Les participants ont souligné une amélioration de leurs résultats cliniques. Ils constatent que les patients ont une meilleure accessibilité, mais l’effet sur la charge de travail et sur la capacité de suivre plus de patients est évaluée de façon variable. CONCLUSION : Le modèle conceptuel proposé permet d’observer empiriquement les dimensions qui font ressortir la valeur ajoutée du développement de la collaboration interprofessionnelle au sein des GMF, ainsi que son impact sur les pratiques professionnelles. / INTRODUCTION: Primary care in the Province of Quebec has undergone a substantial reorganisation over the last several years, on several fronts. Family Medicine Groups (FMG's), designated medical clinics, regional health boards, and local health networks, are only a few examples of new health care delivery components which have been created during this reorganisation. METHODS: This is a case study based on a single Family Medicine Group created during a second wave of innovation. Data was collected via semi-directed interviews with the head physician of the FMG, the group of physicians and nurses within the FMG, the nursing director of the FMG, and the director of nursing at the regional health board. Interviews were conducted until all available contacts were exhausted. The author also accessed the clinical guidelines and the documents used for communication within the FMG. RESULTS: Practice activities in the FMG did evolve over time as a result of mutual clinical and administrative interactions between nurses and physicians. Participants noted a visible improvement in health outcomes as well as increased accessibility to health care by patients. The impact on physician workload, and overall capacity in terms of number of patients followed, after creation of the FMG, were inconsistent. CONCLUSION: This proposed analytic model allows empiric measurement of the added value of FMG's for the development of inter-professional cooperation, and its impact on professional practices.

L’apprentissage des Langues Étrangères a pris une place indispensable dans l’éducation. Avec la mondialisation, différents pays, notamment en Europe et en Amérique, sont contraints de mettre en place des programmes éducatifs pour le développement des compétences communicatives des citoyens dans le but de s’insérer dans l’économie globale. En Colombie, le contexte auquel s’intéresse notre étude, le gouvernement cherche à renforcer l’apprentissage de l’anglais LE. Dans ce but, le Plan National de Bilinguisme (PNB) a été instauré et a entraîné la conception d’objectifs qui ne peuvent être atteints qu’avec de profonds changements dans la pratique professionnelle des enseignants, des acteurs éducatifs et dans l’organisation des établissements scolaires. La présente thèse porte sur les enjeux de cette politique linguistique par rapport au développement professionnel des enseignants d’anglais et à la réalité des contextes éducatifs. Elle porte aussi sur l’impact de l’adoption du Cadre Européen Commun de Référence pour les langues (CECR) comme document de base du PNB. Notre étude, qui s’inscrit dans le domaine de la recherche exploratoire, vise à décrire et comprendre le processus de mise en place du PNB et de l’adhésion du CECR. Nous avons procédé à l’application de différents outils pour le recueil de données – à savoir, l’analyse documentaire, l’entretien semidirectif / compréhensif et le questionnaire – auprès de 13 responsables du développement professionnel et 36 enseignants d’anglais, surtout des régions du Valle del Cauca (ouest) et Cundinamarca (centre). Les données recueillies sont analysées et discutées en vue d’apporter des informations sur la mise en place de la réforme, sur les points de vue des acteurs impliqués, les difficultés rencontrées, et sur le rapport objectives théoriques et réalités d’application. Les résultats obtenus rendent compte de la complexité de mettre en œuvre une politique linguistique cherchant à standardiser les processus d’enseignement-apprentissage des langues étrangères dans un contexte tel que le colombien. Ils nous fournissent des pistes de réflexion sur les besoins urgents de formations, de pratiques réflexives et d’un empowerment chez les enseignants. / Learning Foreign Languages has taken a prominent position in the education field. With globalization, countries, mostly in Europe and America are required to set up educational programs for the development of communicative skills of citizens, to have a place into the global economy. In Colombia, the context in which our study was conducted, the government seeks to reinforce the learning of English FL. To this end, the National Bilingual Program (NBP) established and led the design of objectives that can only be achieved with reflective changes in the professional practice of teachers, the organization of the educational stakeholders and schools. The framework or our research is focused on the stakes of the language policy in relation to professional development of English teachers and the reality of educational contexts. It also looks at the impact of the adoption of the European Framework of Reference for Languages (EFRL) as the basic document of NBP. Our study, is part of an exploratory research, that attempts to describe and understand the implementation process of the NPB and the accession to the CEFR. We proceeded by applying a variety of data collection tools -namely, document analysis, semi-structured/comprehensive interview and questionnaire- with 13 teacher trainers and directors of professional development programs. and 36 English teachers, especially from the regions of Valle del Cauca (west) and Cundinamarca (center). The collected data are analyzed and discussed to provide information on the implementation of the reform, on the views of stakeholders involved, the difficulties encountered and the relation of theoretical objectives and school settings. The outcomes reflect the complexity of implementing a language policy seeking to standardize the process of teaching and learning of foreign languages in a context such as Colombia. This results provide valuable insights on the urgent professional development needs, reflective practices and the empowerment of teachers.

Presentación El siguiente trabajo es un ejercicio reflexivo sobre una experiencia própia: Un estudio etnográfico sobre usuarios/as de heroína realizado en un barrio de Barcelona entre los años 1993-1995. Todo empezó dos años después de escribir la etnografía, al decidir regresar al barrio para explicar a los participantes el trabajo que había escrito sobre aquella experiencia. En esos momentos tomé la decisión de realizar un estudio sobre el papel que yo había desarrollado durante todo el trabajo de campo con esas personas, cómo me había influido, como les había influido, por qué había relatado aquellas cosas sobre sus vidas, qué efectos provocaba lo escrito a posibles lectores, etc. Y así surgió el tema de esta tesis. ObjetivosEn este trabajo me propongo ponerme al lado de los datos que en otro momento recogí y comenzar a analizarlos a la luz de potentes teorías y presupuestos -principalmente de la psicología social-. He tratado de "hacer" un ejercicio reflexivo sobre un caso, una experiencia científica en la qué "yo" he estado implicada. El objetivo fundamental es mostrar en qué consiste una práctica reflexiva, entendida como una forma de hacer "objetivable" el conocimiento (aspecto que correspondería a una dimensión racional- epistemológica), y también entendida como una forma de encontrar resistencias a discursos dominantes en el conocimiento psicosocial (aspecto que correspondería a una dimensión ético-política). Como objetivos específicos me propongo: -señalar un procedimiento que permita conectar al auditorio o lectores con la experiencia particular de la investigadora -cuestionar mi propia práctica de producción de conocimiento psicosocial -explorar los "yoes" o subjetividades en el proceso investigador Marco teórico y metodología He definido un tipo de práctica reflexiva tomando una perspectiva construccionista crítica localizada en la posición del observador/a, donde el valor de la reflexividad, más que instrumento de comprensión o validación, es un instrumento de cambio. Procederé a través del análisis del discurso de mi práctica social o experiencia de conocimiento científico, junto con conceptos provenientes de la etnometodología, interaccionismo simbólico y fenomenología. Los métodos han sido la etnografía de laboratorio (basada en Latour y Woolgar), la descripción etnometodológica (de Potter) y el análisis discursivo (los repertorios interpretativos de Potter y Wheterell, y las formaciones discursivas basadas en Foucault). Mis datos han sido 44 entrevistas en profundidad, a modo de conversaciones con los usuarios y no usuarios significativos en aquel contexto de observación. Casi todas transcritas. Y 5 libretas con notas de campo tomadas durante la observación participante en las que constaban multitud de comentarios personales, interpretaciones sobre el tema y situaciones compartidas entre ellos y "yo". Resultados y discusión Como resultado del análisis del discurso he encontrado la confrontación entre formaciones discursivas "naturalizadoras" y "sociologizadoras", acentuando mucho más en mis datos la formación "sociologizadora" (cuestiones legales, relacionales, culturales, etc.), que "naturalizadora" (cuestiones sensoriales, farmacológicas, psicológicas, fisiológicas, etc.). Este dialogismo entre unas y otras formaciones permite tomar consciencia de formas de acción que no son demasiado relevantes en un contexto sociohistórico dado, pero si se activan o "actúan" en contextos específicos de acción donde las personas tienen capacidad agéntica. La observación participante ha sido fundamental para contextualizar los datos, construidos en su "contexto cotidiano de acción", además, ha dado sentido a las conversaciones y a las entrevistas en profundidad. El procedimiento empleado, conforma un tipo de modelo que pone en relación di versos constructos: contexto discursivo (o interactivo), posición discursiva y formaciones discursivas, y que se articulan alrededor de un espacio intersubjetivo "yo-alter" que es lo que constituye la unidad básica donde opera la reflexividad. Se construyen distintos "yoes" en cada momento y trayectoria de la experiencia relatada. Al introducir el "yo" en el trabajo de campo (tanto el mío como el de alter), provoco una problematización de los datos y a la vez, me obliga a reconceptualizar ese "yo" o "yoes" y resignificar esos datos. Se me plantea mi condición de liminalidad (o de otra manera, decir que no estoy ni dentro ni fuera de la cultura que estudio), donde los contornos de mi identidad se subvierten y donde la condición de ser, es que ninguna subjetividad es permanente. Mi aproximación a "alter" supone una continuidad entre "yo-alter" y en ocasiones resulta amenazante, en la medida en que se confunden los límites y se difuminan con el fin de conseguir una "experiencia empática". Pero no se trataría tanto de una fusión "yo-alter", de manera que sería una dilución de ambos, sino de una permeabilidad de los límites, originando así, un espacio potencial para crear, para conectar y donde se resuelva la tendencia a controlar o contener un "yo" al otro. ConclusionesLa posibilidad de la práctica reflexiva está en el espacio intersubjetivo "yo-alter". Mi intento de conexión con "alter" me constituye temporalmente en mediadora: "estar en medio de". Esto significa: l-socavar los cimientos y el orden construido, a través de buscar fisuras, inconsistencias y contradicciones en los discursos manejados, a partir de las cuales hay potenciales trayectos que no se han producido, 2-incorporar diferentes voces o dialogismo en la historia que cuento y no un monólogo de la autora, sino una participación de alternativas posibles y espacios de enunciación, junto con las subjetividades emergentes. Para ello, dos condiciones son ineludibles: -la agentividad para subvertir lo establecido, las identidades -el recuperar contextos que sean potencialmente relevantes para actuar discursos. Considerar las subjetividades también es la manera de tener a "alter" presente. "Alter" se comprende en "mi" a través de un trayecto en el que se marcan las afinidades mutuas y no tanto las identidades, en el que "representar" a "alter" es trazar un trayecto de conocimiento local y situado (como apunta Haraway), pues sólo así es posible generar una praxis transformadora fiel a la parcialidad. / AN ETHNOGRAPHIC STUDY ON HEROIN USERS. Psycho-social Knowledge and Reflexive Practice This study is a reflexive exercise based on own experience: an ethnographic study of heroin users carried out in a Barcelona city neighbourhood between 1993 to 1995. The aim was to analyse data collected using social psychology theoretic perspectives. I will try to demonstrate what reflexive practice is, understood both as a way of making knowledge "objectivable" (rational-epistemological issues), as well as a way of finding resistance to dominant discourses in psychosocial knowledge (ethical-political issues). The specific aims are: -to indicate a procedure that would approximate the audience or reader with the particular experience of the researcher, -to criticise my own production practice of psycho-social knowledge, -to explore the "self" o subjectivity in the research process. The methods used were: laboratory ethnography (Latour and Woolgar), ethno-methodological description (Potter), discursive analysis (Potter and Wheterell) and discursive training (Foucault). I have carried out 44 interviews and employed 5 fieldwork research reports. In the procedure used, I have linked: discursive context, position and discursive training. These elements are articulated around an "alter-self" inter-subjective space, constituting the basic unit out of which reflexivity operates. In my narrative, "sociologising" training discourses (i.e. legal, relational, cultural matters etc.) have predominated over those which are "naturalising" (i.e. sensorial, pharmacological, psychological matters etc.). Different "self" are formed at every moment and throughout the development of the narrated experience. By introducing the "self" in the tieldwork (both the "self" as well as the "alter"), I introduce a problemising of the data. At the same time, I reconceptualise the "self" and resignify the data. In conclusion, it is worth pointing out that the possibility of reflexive practice is on the "alter-self" intersubjective space, and my attempt to connect with the "alter", temporarily makes me a "mediator". This means: -undermining the foundations and the order built, by searching for weaknesses and inconsistencies in discourses. Starting from this generates ways that had not been made. -Incorporating different voices o dialogisms in the history, together with emerging subjectivities. Two conditions are unavoidable: - the agentivity for subverting what is established, the identities, - to recuperate contexts which are potentially relevant for carrying out discourses.

This investigation aimed to shed light on the terms of the dispensing and the retaining of municipal social benefits granted by Swedish social services, this in regard of a less visible societal subgroup; citizens who cannot attain or retain housing of their own. Through qualitative interviews with six municipal social workers in Skåne, the plight of these citizens is revealed from a policy-making perspective in respect of views on discretion and individual appreciation. How may the applicant impact the application process and how does social subletting operate as a service effort? Further analysis of the accounts of informants’ views on change and the reasons for change, sketched an image of a society where public acceptance and tolerance are crucial factors for citizens hoping to achieve a homestead through means of municipal intervention. In conclusion, flexible attitudes towards job description are of major import to the possibility of offering client support in under-staffed municipal environs. Furthermore, reflexive social workers allying with the applicant throughout the process, from application to intervention are decisive for efficacious, long-term social work.

INTRODUCTION : Les soins de première ligne au Québec vivent depuis quelques années une réorganisation importante. Les GMF, les cliniques réseaux, les CSSS, les réseaux locaux de service, ne sont que quelques exemples des nouveaux modes d’organisation qui voient le jour actuellement. La collaboration interprofessionnelle se trouve au cœur de ces changements. MÉTHODOLOGIE : Il s’agit d’une étude de cas unique, effectuée dans un GMF de deuxième vague. Les données ont été recueillies par des entrevues semi-dirigées auprès du médecin responsable du GMF, des médecins et des infirmières du GMF, et du cadre responsable des infirmières au CSSS. Les entrevues se sont déroulées jusqu’à saturation empirique. Des documents concernant les outils cliniques et les outils de communication ont aussi été consultés. RÉSULTATS : À travers un processus itératif touchant les éléments interactionnels et organisationnels, par l’évolution vers une culture différente, des ajustements mutuels ont pu être réalisés et les pratiques cliniques se sont réellement modifiées au sein du GMF étudié. Les participants ont souligné une amélioration de leurs résultats cliniques. Ils constatent que les patients ont une meilleure accessibilité, mais l’effet sur la charge de travail et sur la capacité de suivre plus de patients est évaluée de façon variable. CONCLUSION : Le modèle conceptuel proposé permet d’observer empiriquement les dimensions qui font ressortir la valeur ajoutée du développement de la collaboration interprofessionnelle au sein des GMF, ainsi que son impact sur les pratiques professionnelles. / INTRODUCTION: Primary care in the Province of Quebec has undergone a substantial reorganisation over the last several years, on several fronts. Family Medicine Groups (FMG's), designated medical clinics, regional health boards, and local health networks, are only a few examples of new health care delivery components which have been created during this reorganisation. METHODS: This is a case study based on a single Family Medicine Group created during a second wave of innovation. Data was collected via semi-directed interviews with the head physician of the FMG, the group of physicians and nurses within the FMG, the nursing director of the FMG, and the director of nursing at the regional health board. Interviews were conducted until all available contacts were exhausted. The author also accessed the clinical guidelines and the documents used for communication within the FMG. RESULTS: Practice activities in the FMG did evolve over time as a result of mutual clinical and administrative interactions between nurses and physicians. Participants noted a visible improvement in health outcomes as well as increased accessibility to health care by patients. The impact on physician workload, and overall capacity in terms of number of patients followed, after creation of the FMG, were inconsistent. CONCLUSION: This proposed analytic model allows empiric measurement of the added value of FMG's for the development of inter-professional cooperation, and its impact on professional practices.

This dissertation is a report on research into the development and evaluation of a career assessment and counselling procedure that falls under the aegis of the constructivist, narrative approach: My Career Chapter: A Dialogical Autobiography. My Career Chapter enables an individual to construct a holistic understanding of his or her career. The procedure facilitates an individual writing and reflecting on an autobiographical account of his or her career that is contextualised amidst systems of career influences. The resulting autobiographical text can be used in career counselling, including co-constructive dialogue between client and counsellor. The literature underpinning the research project is described with a wide-ranging discussion of issues that critically pertain to the research endeavour and essentially provide a primary base for the work. Two theoretical frameworks that exemplify constructivism in vocational psychology underpin the research: the Systems Theory Framework and the Theory of Career Construction. From the base of those two theoretical frameworks, narrative career counselling is explicated and exemplars are described. The Theory of Dialogical Self is introduced to inform the design of My Career Chapter and, ultimately, the theory and practice of narrative career counselling. The research is predominantly positioned within a paradigm of constructivism/interpretivism and the results of the studies are collectively interpreted accordingly; but postpositivism and critical ideological paradigms are present in a secondary form due to the mixture of research methods used in the project as a whole. Six empirical studies investigate the experience of My Career Chapter from the perspective of the developer, the counsellor-user, and the client-user; each explicated with two studies respectively. Research methods include autoethnography for the developer's experience, interpretative phenomenological analysis and focus group for the counsellor-users' experience, and quasi-experiment and interpretative phenomenological analysis for the client-users' experience. The studies of the developer's experience of My Career Chapter comprehensively explicate how and why the procedure was developed and emphasise the importance of reflexive science and practice. Crucially, the autoethnographies revealed a nexus of theory-practice-person which underpins the production of My Career Chapter, and critically influences the entire research project. The studies involving counsellor-users affirmed My Career Chapter's alignment with recommendations for the development and application of qualitative career assessment and counselling procedures. These studies also raised questions pertaining to the characteristics of client-users that may mediate the efficacy of the procedure (e.g., age, language ability). Studies of client-users firstly support the conclusion that My Career Chapter is a safe career assessment and counselling procedure, with minimal attendant risk of inducing psychological harm or distress. The procedure was experienced as being helpful as a tool for personal reflection, through its theoretically-derived processes of facilitating clients writing, reading, and hearing and talking their autobiographical manuscripts through in the interpretation phase. There are four dimensions of significance associated with this research project. Firstly, the divide between theory and practice has indeed been much lamented in vocational psychology and counselling psychology. Thus, the overall significance of the research reported upon in this dissertation is significant because it attempts to bring theory and practice together through a reflexive and theoretically informed research process into a career assessment and counselling procedure. Secondly, the research and development process produced a new career assessment and counselling product which will add to the limited range of techniques that fall under the aegis of constructivist career assessment and counselling broadly, and the narrative approach specifically. My Career Chapter complements other procedures. Thirdly, two of the research methods used in the project (viz., autoethnography and interpretative phenomenological analysis) demonstrated their potential as additional qualitative methods for research within vocational psychology. Finally, the research process has enabled the articulation of the Theory of Dialogical Self—from another branch of psychology—into the extant corpus of literature on career development theory and practice.